Dr. Vu Ngoc Truong came to Canada as a Vietnamese refugee. He got into medical school and became a respected, popular urologist doing surgery throughout the Fraser Health region.

But after pleading guilty next month to a fraud charge related to overbilling, he will have a criminal record. He could lose his hospital privileges and face a suspension by the College of Physicians and Surgeons of B.C. However, that is not a certainty, according to College spokeswoman Susan Prins.

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“There are many factors that the Inquiry Committee will need to consider, just as in a criminal sentencing,” Prins said. “The College’s Inquiry Committee opens a file and considers the nature of the offence and whether the circumstances give rise to a registrant’s competence or fitness to practice.”

The Burnaby urologist is believed to be the first doctor in about 20 years to face criminal prosecution related to improper billing. His fraud charge was due to work done by a special investigations unit established by the B.C. Ministry of Health in 2015 to investigate overbilling.

Truong, who has not agreed to an interview, performs adult and pediatric surgery at Burnaby General, Royal Columbian and Eagle Ridge hospitals. After getting a Bachelor of Science degree from the University of B.C. in 1995, he got a medical degree in 2000 and then spent the next five years doing specialty training. He did a fellowship at the Alberta Urology Institute in Edmonton, focusing on minimally invasive (laparoscopic) surgery and is considered an expert in nerve-sparing surgery to remove cancerous prostate glands and cancerous kidneys.

In its latest (2015/16) annual report, the Medical Services Commission said there were 21 audits conducted on doctors and 16 cases were pursued for recovery of overbilling for $4.77 million. Truong was one of the doctors ordered to repay the government. According to commission reports, the billing errors by Truong amounted to about $1 million between 2007 and 2012. But his lawyer, Terry Robertson, said Truong negotiated an undisclosed but far lower repayment that he believes has been paid in full.

Robertson said it is unclear if a judge will sentence Truong on March 3, the day he is expected to plead guilty in provincial court. Robertson and his firm, Harper Grey, are typically only retained by the doctors’ legal defence organization — Canadian Medical Protective Association (CMPA) — when doctors are sued for matters like malpractice. But the CMPA made an exception in this case, he said, because the firm had been involved in the audit matter and the fraud charge is being handled expeditiously, with a guilty plea.

The fraud charge pertains to one bill involving a single surgical procedure, Robertson said. The amount billed was about $20,000.

“Dr. Truong is a highly respected surgeon with extraordinary skill. He has tremendous remorse and will accept his punishment,” Robertson said in an interview.

Truong’s gross billings skyrocketed from just under $200,000 in 2007 to an average of $700,000 annually during the years when he was audited. In 2013 and 2014, he billed the Medical Services Plan $808,000, but the latest annual report shows billings of $741,000. According to audit documents filed in court, Truong allegedly billed incorrectly for hospital visits, office procedures and other services.

Urologists who were interviewed (but asked not to be named) about Truong all expressed disappointment over his plight, especially because he overcame so much as a refugee and is an impressive surgeon.

Health care fraud, mostly by doctors, has been estimated at $10 billion a year across Canada, a report prepared for the Law Commission of Canada in 2005 by Simon Fraser University criminology professor Joan Brockman showed. But governments and doctors have historically taken a non-criminal approach to medicare fraud.

“The B.C. model is based on education, warnings, reconciliation and assistance; if that doesn’t work, the interest appears to be in recovery of money, not prosecution or punishment,” Brockman said in an earlier interview.

Brockman said in her paper, Fraud Against the Public Purse by Health Care Professionals, that fraud is uncommon – somewhere between 0.5 per cent and five per cent of doctors overbill intentionally and the most prevalent cases involve “phantom” services to patients.

Criminal charges are even more rare; Brockman found reports of only three criminal cases involving B.C. doctors between 1990 and 2003. There are about 10,000 doctors in B.C. who bill on a fee for service (as opposed to salaries or other contracts) basis.

Brockman, whose area of expertise is white collar crime, said physicians and other professionals are more difficult to prosecute because they always have good legal representation.

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